Division of Environmental Health, World Health Organization (retired), Newark, DE, USA.
Acta Paediatr. 2014 Feb;103(2):188-93. doi: 10.1111/apa.12482. Epub 2013 Dec 20.
Male excess infant mortality is well known but unexplained. In 2004, we reported sudden infant death syndrome (SIDS) and other infant respiratory deaths showed a ~50% male excess in the United States between 1979 and 2002. This study analyses expanded US data from 1968 to 2010 to see whether infant respiratory deaths still show similar ~50% male excess and may be X-linked.
The analysis compared infant mortality data from the US Centers for Disease Control and Prevention, 1968-2010, with 11 World Health Organization International Classification of Diseases (ICD) rubric groups for respiratory deaths by accidents, congenital anomalies, respiratory diseases and causes unknown.
The 11 ICD groupings presented male excesses of ~50% and combining the 453,953 US cases produced a male fraction of 0.6034, a 52.1% male excess. A further 72,380 non-US respiratory cases showed a similar 0.6055 male fraction, a 53.5% male excess.
The constant ~50% male excess for quite different causes of respiratory death suggests they all have a common terminal event and that is acute anoxic encephalopathy. We hypothesise that this constant male excess phenomenon must be caused by a single X-linked gene, with a recessive condition, leading to a predisposition to succumb to acute anoxic encephalopathy.
众所周知,男性婴儿死亡率偏高,但原因尚未得到解释。2004 年,我们曾报告称,1979 年至 2002 年期间,美国的婴儿猝死综合征(SIDS)和其他婴儿呼吸系统死亡病例中,男性婴儿死亡率偏高约 50%。本研究分析了美国从 1968 年到 2010 年的扩展数据,以观察婴儿呼吸系统死亡病例是否仍显示出类似的偏高约 50%的性别差异,以及是否与 X 连锁遗传有关。
该分析比较了美国疾病控制与预防中心(Centers for Disease Control and Prevention)1968 年至 2010 年的婴儿死亡率数据,以及世界卫生组织(World Health Organization)国际疾病分类(International Classification of Diseases)11 个 ICD 类目下的意外、先天性异常、呼吸疾病和不明原因的呼吸死亡。
这 11 个 ICD 类目均显示出偏高约 50%的男性比例,将 453953 例美国病例合并后,男性比例为 0.6034,男性比例偏高 52.1%。另外 72380 例非美国的呼吸病例也显示出类似的男性比例 0.6055,男性比例偏高 53.5%。
导致呼吸死亡的原因截然不同,但男性比例均偏高约 50%,这表明它们都有一个共同的终末事件,即急性缺氧性脑病。我们假设,这种持续的男性比例偏高现象一定是由单个 X 连锁基因引起的,这种基因呈隐性遗传,导致对急性缺氧性脑病的易感性增加。